Article Dans Une Revue Kidney International Reports Année : 2024

Anti-PLA2R1 antibodies and membranous nephropathy recurrence after kidney transplantation

1 UCA Faculté Médecine - Université Côte d'Azur - Faculté de Médecine
2 URRIS UR2CA - Unité de Recherche Clinique de la Côte d’Azur
3 CHU Nice - Centre Hospitalier Universitaire de Nice
4 Département de Néphrologie - Hôpital Pasteur [Nice]
5 HCL - Hospices Civils de Lyon
6 Département Maladies Infectieuses et Tropicales [CHRU Montpellier]
7 IPMC - Institut de pharmacologie moléculaire et cellulaire
8 Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM]
9 MEPHI - Microbes évolution phylogénie et infections
10 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
11 Hôpital Edouard Herriot [CHU - HCL]
12 UCBL - Université Claude Bernard Lyon 1
13 CUMR Caen - Centre Universitaire des Maladies Rénales [CHU Caen]
14 UNICAEN Santé - Université de Caen Normandie - UFR Santé
15 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
16 CHU Tenon [AP-HP]
17 CoRaKID - Maladies rénales fréquentes et rares : des mécanismes moléculaires à la médecine personnalisée
18 Service de néphrologie et hémodialyse [CHU de Strasbourg]
19 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
20 Hôpital Henri Mondor
21 Université Paris-Saclay
22 CHU Gabriel Montpied [Clermont-Ferrand]
23 Service Néphrologie, Hémodialyses [CHU Clermont-Ferrand]
24 CHU Henri Mondor [Créteil]
25 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
26 Service de Néphrologie [CHRU Besançon]
27 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
28 Service de Néphrologie [Nantes]
29 CHU de Bordeaux Pellegrin [Bordeaux]
30 Service de Néphrologie-transplantation-dialyse [Bordeaux]
31 Service de Néphrologie-Dialyse-Transplantation [CHU Amiens-Picardie]
32 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517
33 CHU - BREST - Nephrologie - CHRU Brest - Service de Nephrologie
34 Service de néphrologie [Rennes]
35 Irset - Institut de recherche en santé, environnement et travail
36 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
37 Service de Néphrologie Dialyse, Transplantation rénale [CHU Saint Etienne]
38 Département de Néphrologie et Transplantation d'organes [CHU Toulouse]
39 CHU Angers - Centre Hospitalier Universitaire d'Angers
40 AP-HP - Hopital Saint-Louis [AP-HP]
Eric Rondeau
  • Fonction : Auteur
Nacera Ouali
  • Fonction : Auteur

Résumé

Introduction: Membranous nephropathy can lead to end-stage kidney disease, for which kidney transplantation is the preferred therapy. However, the disease often relapses, which can impact allograft survival. Methods: We conducted a prospective multicenter study in France involving 72 patients with membranous nephropathy who were awaiting and then underwent kidney transplantation. In addition, we established a retrospective validation cohort of 65 patients. The primary objective was to evaluate the prognostic significance of pretransplant anti phospholipase A2 receptor 1 (PLA2R1) antibodies on the recurrence of membranous nephropathy. The study also assessed the incidence rate, time to onset, and risk factors for recurrence, as well as allograft outcome. Results: The prospective cohort showed a 26% cumulative incidence of membranous nephropathy recurrence after a median follow-up of 23.5 months. This was confirmed by a 28% cumulative incidence after a median follow-up of 67 months in the retrospective cohort. A strong association was found between the presence of anti-PLA2R1 antibodies prior to transplantation and the risk of disease recurrence (risk ratio = 5.9; 95% confidence interval [CI]: 2.3-15.7; P < 0.0001). These results were confirmed in the retrospective cohort. Monitoring of anti-PLA2R1 antibodies in the immediate posttransplant period is of limited value, because recurrence occurred early in the first 6 months (median delay of 5 [3-14] months) after transplantation despite decreasing antibody levels. Conclusion: The presence of anti-PLA2R1 antibodies prior to transplantation was a strong predictor of recurrence of allograft membranous nephropathy. An individualized immunomonitoring and management strategy for kidney transplant candidates with anti-PLA2R1-associated membranous nephropathy should be considered.
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hal-04711258 , version 1 (08-11-2024)

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Marion Cremoni, Maxime Teisseyre, Olivier Thaunat, Céline Fernandez, Christine Payre, et al.. Anti-PLA2R1 antibodies and membranous nephropathy recurrence after kidney transplantation. Kidney International Reports, 2024, 9 (12), pp.3427-3438. ⟨10.1016/j.ekir.2024.09.012⟩. ⟨hal-04711258⟩
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